surface tailoring of aluminum sheets by pvd sputtering

Abstract In order to change surface morphology of aluminum sheets, they have been mounted as targets in a PVD sputtering system, and subjected to several sputtering cycles. As an effect of the plasma erosion, sheet surface continuously changes during multiple sputtering cycles. First results are shown in terms of surface morphology. The levelling effect of the plasma erosion is evident as initial irregularities from rolling partially disappear, and surface profiles become smoother by increasing number of cycles. That is the first result in the direction of surface tailoring, and nano-grooves could be expected at very high numbers of cycles. Surface nano-tailoring would be the first step for the production of patterns in injection molding of common polymers

SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality (5.4 (95%CI 4.3-6.7)). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly

Understanding the long‐term impact of the COVID‐19 pandemic on non‐muscle‐invasive bladder cancer outcomes: 12‐Month follow‐up data from the international, prospective COVIDSurg Cancer study

Objective: The objective of this study was to report the 12-month oncological outcomes for patients with non-muscle-invasive bladder cancer (NMIBC) within the prospective, international COVIDSurg Cancer study. Patients and methods: Eligible patients were aged ≥18 years and scheduled for elective surgical management of NMIBC with curative intent (transurethral resection of bladder tumour [TURBT] or bladder biopsy) from 21 January to 14 April 2020. The primary outcome was disease recurrence within 12 months of previous elective TURBT/bladder biopsy. Secondary outcomes included disease progression within 12 months of previous elective TURBT/bladder biopsy, site-declared delay to surgery from diagnosis as a consequence of COVID-19 and deviation in standard care due to COVID-19. Comparisons were made to cohorts from the pre-pandemic era. Results: Bladder cancer accounted for 2.2% (n = 446) of patients in the COVIDSurg Cancer study, with data contributed by 27 centres across 12 countries internationally. Within this included cohort, 229 patients had NMIBC and 12-month follow-up data available. On application of National Institute for Health and Care Excellence (NICE) criteria, 47.2% were classified as having high-risk disease. Overall disease recurrence and progression rates were 29.3% and 9.7% at 12 months, respectively. In purely high-risk pre-pandemic cohorts, the International Bladder Cancer Group (IBCG) estimates a recurrence rate of 25% at 12 months, and the European Association of Urology (EAU) NMIBC 2021 scoring model estimates a 12-month progression rate of 3.5%. As a consequence of the COVID-19 pandemic, 10.9% of patients had site-declared delay to TURBT/bladder biopsy; 7.4% did not undergo intravesical therapy or had early discontinuation of this; 9.2% did not undergo early repeat resection for high-risk disease; and 18.3% had a delay to cystoscopic follow-up surveillance. Conclusions: This prospective study indicates that there were widespread deviations in usual care for NMIBC during the pandemic and that 12-month oncological outcomes appear to be impaired compared to published pre-pandemic outcomes

Defining the role of multiparametric MRI in predicting prostate cancer extracapsular extension

To identify the predictive factors of prostate cancer extracapsular extension (ECE) in an institutional cohort of patients who underwent multiparametric MRI of the prostate prior to radical prostatectomy (RP). Overall, 126 patients met the selection criteria, and their medical records were retrospectively collected and analysed; 2 experienced radiologists reviewed the imaging studies. Logistic regression analysis was conducted to identify the variables associated to ECE at whole-mount histology of RP specimens; according to the statistically significant variables associated, a predictive model was developed and calibrated with the Hosmer-Lomeshow test. The predictive ability to detect ECE with the generated model was 81.4% by including the length of capsular involvement (LCI) and intraprostatic perineural invasion (IPNI). The predictive accuracy of the model at the ROC curve analysis showed an area under the curve (AUC) of 0.83 [95% CI (0.76-0.90)], p < 0.001. Concordance between radiologists was substantial in all parameters examined (p < 0.001). Limitations include the retrospective design, limited number of cases, and MRI images reassessment according to PI-RADS v2.0. The LCI is the most robust MRI factor associated to ECE; in our series, we found a strong predictive accuracy when combined in a model with the IPNI presence. This outcome may prompt a change in the definition of PI-RADS score 5. The online version contains supplementary material available at 10.1007/s00345-023-04720-5

Manufacturing of a Shape Memory Polymer Actuator

Shape memory polymer (SMP) foams can be used to manufacture actuators with tailored actuation rate. Being related to foam shape recovery by heating, SMP actuator operates by conversion of heat into motion. In the current study, a SMP linear actuator has been manufactured which is able to apply a maximum load of 50 N (depending on the recovery temperature) and a maximum stroke up to 30 mm. The actuator had a cylindrical shape and its piston had a diameter of 16 mm, therefore a maximum applied pressure about 2.5 bar. The active element (i.e. SMP foam) was produced by solid state foaming of an epoxy resin, and its shaping was performed in the same metallic frame of the actuator. Results show that small and medium-size actuators can be easily produced and operated.</jats:p

Frozen Stresses in Shape Memory Polymer Composites

Shape Memory Polymer Composites (SMPCs) are a class of smart materials in which the structural properties of long-fiber polymer-matrix composites and the functional behavior of Shape Memory Polymers (SMP) are combined together. In this study, the frozen stresses resulting from fixing a deformed shape have been investigated. Two different samples were manufactured, with and without significant shape memory properties, and a three point flexural test equipment was used in order to fix a deformed shape. The forces and the resulting stresses were measured during the samples deformation and after the shape freezing. The experimental tests have shown that the shape memory sample has a better ability to fix a deformed shape, since its frozen stress is higher in all the tests. </jats:p

The specialist trained nurse`s importance and role in the psychiatric outpatient care from management`s perspectives

Bakgrund: Psykiatrisjuksköterskan har historiskt sett pendlat mellan att vara omvårdnadsansvarig till att vara förlängd arm till andra yrkeskategorier som till exempel läkare. Studier visar att specialistsjuksköterskan har en komplex kompetens som hen upplever inte alltid lyfts av organisationen och att hen ofta upplever sig klämd emellan patienters, medarbetares och organisationens krav. Specialistsjuksköterskor i psykiatrisk vård börjar nu bli en bristvara och då deras roll, status och betydelse framstår som diffus   kan det bli svårt att rekrytera nya sjuksköterskor att utbilda sig och stanna kvar inom psykiatrisk vård. Då mycket få studier är genomförda i psykiatrisk öppenvård och med ledningsperspektiv var det av intresse att tillfråga just enhetschefer med ansvar att anställa personal. Syfte: Att beskriva enhetschefers uppfattningar om och förväntningar på specialistsjuksköterskans betydelse och roll i psykiatrisk öppenvården. Metod: Studien genomfördes som en empirisk intervjustudie med semistrukturerade frågor som ställdes individuellt till sju enhetschefer verksamma inom psykiatrisk öppenvård. Materialet bearbetades med en kvalitativ innehållsanalys med induktiv ansats. Resultat: I resultatet framkom huvudkategorin ”Arbetsuppgifter och förväntningar” med underkategorierna Bedömningar, Samordnande och samverkande roll, Läkemedelsadministrering, Utvecklingsarbete, Flexibla ansvarsområden, Bemötande och kommunikation samt Kompetens. Diskussion: Specialistsjuksköterskan har många olika roller att träda in i inom psykiatrisk öppenvård och förväntas använda sin kompetens där den behövs.Background: Psychiatric nurses has historically oscillated between being responsible of nursing care to be an extended arm to other professionals such as physicians. Studies show that the specialist nurse has a complex competence that according to the nurses is not always highlighted by the organization and often find themselves trapped between patients, other employees and the organization's demands. Specialist nurses in psychiatric care are now becoming scarce and when their role, status and importance appears diffuse, it may be difficult to recruit new nurses to train and remain in psychiatric services. Since very few studies have been carried out in outpatient psychiatric services and management perspective, it was of interest to the matter to ask the views of unit managers with responsibility to hire staff. Aim: To describe unit managers' perceptions and expectations of the specialist nurse's importance and role in psychiatric outpatient services. Method: The study was conducted as an empirical interview study with semi-structured questions that were asked individually to seven unit managers occupied in psychiatric outpatient care. The material was processed with a qualitative content analysis with inductive approach. Results: The result showed the main category "Duties and expectations" with the subcategories Assessments, Coordinating and cooperative role, Drug administration, Development, Flexible responsibilities, Treatment and communication as well as Competence. Discussions: The specialistnurse has many variable roles to enter in psychiatric outpatient care and are expected to use their expertise where it is needed

Effects of Micro-Textured Polystyrene Substrates by Compression Molding on Cell Adhesion and Proliferation

Surface chemistry and micro-nanoscale topography of biomaterials can significantly influence tissue engineering and cell biology. In this study, polystyrene (PS) Petri dishes were subjected to microtexturing by compression molding process, which resulted in three-dimensional (3D) microscale surface topographies. Three different micropatterned surfaces were fabricated using bronze sintered molds with different mean pore pitch sizes. The surface changes and the morphological aspects were analyzed by 3D surface analyzer. The dishes were then used to investigate the cell behavior of Mouse Embryonic Fibroblasts (MEF) P4 cells. The surface micropatterning have affected in different ways the MEF cell adhesion and proliferation, related to the morphological changes in comparison with unmodified PS. At the increasing of the sintered particle dimensions of the mold, the cavities dimensions on the molded Petri increase and also the cells adhesion in the cavities seems to increase independently from the roughness inside them. </jats:p

Resilience of elective cancer surgery systems during COVID-19 lockdowns: an international, multicentre, prospective cohort study

Background Surgery is the main modality of cure for solid cancers and was prioritised to continue during SARS-CoV-2 outbreaks. This study aimed to identify areas for health system strengthening by comparing the delivery of elective cancer surgery during COVID-19 in periods of lockdown versus light restriction. Methods In this international, multicentre, prospective cohort study, we enrolled patients with 15 cancer types who had a decision for surgery during the SARS-CoV-2 pandemic (between Jan 21, 2020 and April 14, 2020) to Aug 31, 2020. Any hospital worldwide providing elective cancer surgery was eligible. The primary outcome was the non-operation rate (proportion of patients who did not undergo planned surgery). Reasons for non-operation were classified as COVID-19 related (societal, operational, or personal) or unrelated. Average national Oxford COVID-19 Stringency Index scores were calculated for each patient during their wait for surgery and classified into light restrictions (index &lt;20), moderate lockdowns (20–60), and full lockdowns (&gt;60). Cox proportional-hazards regression models were used to explore associations between lockdowns and non-operation. This study was registered at ClinicalTrials.gov, NCT04384926. Findings We enrolled 27 700 participants, of whom 20 006 patients (8526 men and 11480 women) from 466 hospitals and 61 countries did not receive surgery after a minimum of 3-months' follow up (median 23 weeks [IQR 16–30]). All patients had a COVID-19-related reason for non-operation. Light restrictions were associated with a 0·6% reference non-operation rate, moderate lockdowns with a 5·5% rate (HR 0·81, 95% CI 0·77–0·84, p&lt;0·0001), and full lockdowns with a 15·0% rate (0·51, 0·50– 0·53, p&lt;0·0001). In sensitivity analyses, including adjustment for SARS-COV-2 case notification rates, moderate (0·84, 0·80–0·88; p&lt;0·001), and full lockdowns (0·57, 0·54–0·60; p&lt;0·001) remained independently associated with non-operation. Frail patients with advanced cancer, particularly those from low-income and middle-income countries and those requiring postoperative critical care, were more likely to not have an operation. Interpretation Cancer surgery systems worldwide were affected by lockdowns, including in the UK, with one in seven patients not undergoing planned surgery. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which could include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies. In the UK, a whole-health system approach is required to mitigate against further harm for NHS patients. Funding National Institute for Health Research (NIHR) Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, Economic and Social Research Council, European Society of Coloproctology, Medtronic, NIHR Academy, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research